In a principal aspect the present invention relates to a lumbar support device, a selective stabilization support device and a method of treating mechanical lower back pain using a lumbar support device. In particular, the present invention relates to a versatile lumbar support device and a versatile selective stabilization support device for providing selective stabilization of a localized area of a patient's back or neck.
Mechanical back pain is a problem that affects a large proportion of the population at some point in their lives. The pain often occurs as a result of damage to the discs that are provided between the vertebrae in the spine. Damage to these discs can, in turn, result in more pressure being applied to nerve roots, which leads to pain. As people get older, the discs lose hydration and tend to narrow, thus increasing the pressure on the nerve roots. In younger people, the fibers that form the outer walls of the intervertebral discs can become damaged, resulting in fissures in the outer walls of the discs. As the fibers break down, the gel-like substance contained within the disks leaks out, reducing the effectiveness of the discs and increasing the pressure on the surrounding nerves and ligaments. The resulting instability can reduce or block a patient's range of movement and cause pain, weakness and sensory changes. Another cause of back pain is spondylolisthesis, an instability caused by the shifting of one vertebra over another. These types of damage to the spine often occur gradually as a result of poor posture and excessive bending of the back.
At present, mechanical back pain such as that described above is often treated by prescribing drugs to the patient. However, although drugs may reduce the pain experienced by the patient and may reduce the inflammation, they do not address the underlying cause of the pain. Furthermore, surgery is sometimes used to address problems in the spine, for example to remove a damaged segment and to fuse the neighboring vertebrae. Surgery, however, is expensive and invasive, and often does not provide a long lasting solution.
In addition, methods and devices are known for rigidly bracing a patient's back, such as that disclosed in U.S. Pat. No. 5,259,831 for applying rigid thermoplastic panels to the chest and back of a patient to brace the patient's back. The panels provide general support over a large region of the patient's back, but severely restrict the movement of the patient.
Furthermore, devices are also known for providing general support to the lower back region to reduce the likelihood of damage occurring or to treat injury. For example, U.S. Pat. No. 6,319,217 discloses a lumbosacral support pad comprising a moisture-curable resin that hardens upon curing to form a rigid structure that retains its post-curing shape. The support pad is cured in situ on the patient's back such that the resin adopts the contours of the patient's back. Thereafter, the support pad provides general support over the lumbar region of the patient's back. In U.S. Pat. No. 6,666,838 there is disclosed a low profile lumbo-sacral orthosis for providing general support to a patient's back to reinforce proper body ergonomics.
These prior art devices are, however, only able to provide general support over the patient's lumbar region. In treating disc derangement, it is desirable to centralize the pain and to therefore reduce the extent of peripheralization, which is the radiation of the pain from a central region to distal regions of the body. For example, back pain may radiate down a patient's legs or other regions.
A known and respected technique for helping to analyze and treat a patient's back pain is the McKenzie Approach. The McKenzie approach involves an organized and systematic mechanical evaluation, categorization and treatment technique for helping to centralize and manage a patient's back pain. According to this approach, the patient's back pain is analyzed by considering the patient's history of back pain, their symptoms, the factors that aggravate or improve the pain and by classifying the pain according to a series of sub-classifications. The McKenzie approach can be used, for example, to determine whether a patient has a central lesion of a disc, or a lesion to one side of the disc, and can help categorize mechanical lesions. Furthermore, the McKenzie approach is used to determine the optimum locations, directions and quantities of pressure to apply to selected locations on the patient's back in order to stabilize and centralize the pain.
The patient can then be maneuvered into particular positions by a therapist to help to centralize the pain. This approach is generally successful at helping to reduce a patient's symptoms. However, it is not possible to maintain a patient in these positions such that they are provided with selective stabilization of localized regions of the back for a prolonged period of time. Furthermore, the prior art devices outlined above are not able to provide versatile selective stabilization.
It is therefore desirable to provide support devices that are capable of providing the necessary localized support to selected regions of a patient's back. Furthermore, it is desirable that such support devices be easy to don and doff, comfortable to wear and configurable to different configurations so as to provide the desired support.